MEDICARE: DR. DANIEL J. KERBACHER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	MD023726E	PA

General Provider Information

NPI Number	:	1598767519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL J. KERBACHER M.D.

Provider Business Mailing Address
First Line	:	436 E 11TH ST
Second Line	:
City	:	BERWICK
State	:	PA
Zip	:	18603-2228
Country	:	US
Telephone Number	:	570-759-1012
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 ROUTE 522
Second Line	:
City	:	SELINSGROVE
State	:	PA
Zip	:	17870-8707
Country	:	US
Telephone Number	:	570-372-5690
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	05/02/2008

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